scholarly journals The Use and Effectiveness of Advanced Directives in the End of Life Care of Trauma Patients

2015 ◽  
Vol 221 (4) ◽  
pp. S84-S85
Author(s):  
Ali Darehzereshki ◽  
Shahram Aarabi ◽  
Samuel P. Mandell ◽  
Frederick P. Rivara ◽  
J. Randall Curtis ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Trauma Patients ◽  
Life Care ◽  
Advanced Directives

Nurse and Physician Preferences for End-of-Life Care for Trauma Patients

2010 ◽  
Vol 69 (6) ◽  
pp. 1567-1573 ◽  
Author(s):  
Lenworth M. Jacobs ◽  
Karyl J. Burns ◽  
Barbara Bennett Jacobs
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Trauma Patients ◽  
Life Care

Dialogues in Diversity: An Invited Series of Papers, Advance Directives, DNRs, and End-of-Life Care for African Americans

2006 ◽  
Vol 52 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Ronald Keith Barrett
Keyword(s):  
African American ◽  
African Americans ◽  
End Of Life ◽  
Advance Directives ◽  
End Of Life Care ◽  
Clinical Care ◽  
Life Care ◽  
Advanced Directives ◽  
Culturally Sensitive Care ◽  
Care Giving

The article utilizes a meta-analysis of the existing empirical research and theory on health care directives to provide some insights into the documented pattern of African Americans to use advance directives less than Whites. A number of relevant factors are highlighted and examined. In addition the article attempts to provide some insights into African American family life and traditional values regarding the care of the elderly and end-of-life care. The African American tradition of employing a family-centered decision making process during family crisis, as well as a significant cultural mistrust of institutionalized care is also explored. The article also attempts to offer some practical suggestions for clinical care givers working with African Americans to enhance culturally sensitive care giving and the utilization of advanced directives among African Americans at the end-of-life.

Factors Associated With Implementation of the POLST Paradigm: Results From a Survey of Florida Physicians

2013 ◽  
Vol 14 (4) ◽  
pp. 247-253 ◽  
Author(s):  
Juliana J. Matthews ◽  
Carly Elizabeth Souther
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Planning Process ◽  
Treatment Options ◽  
Life Care ◽  
Cross Sectional ◽  
Advanced Directives ◽  
Life Planning ◽  
Barriers And Opportunities ◽  
June July

Objectives: To investigate physicians’ awareness and attitudes regarding the Physician Orders for Life-Sustaining Treatment (POLST) concept and to identify barriers and opportunities for its expansion.Design: Cross-sectional questionnaire, using electronic survey instrument.Setting: Community.Patients: 212 physicians from three Florida medical associations and the Florida State University College of Medicine clinical faculty responded to the survey. Of those, 67.9% were familiar with the concept of POLST.Measurements and Main Results: Data were collected using a web-based survey, completed in June–July 2012, consisting of qualitative and quantitative questions. Most (95.8%) agreed or strongly agreed that it was a physician’s responsibility to discuss end-of-life care and treatment options with patients. Satisfaction with current advanced directives was highly variable. However, a consensus about potential benefits of POLST exists, including assisting the discussion of end-of-life care, decreasing unwanted treatment, and lowering costs. More than 70% of respondents reported they would be more likely to use the POLST form if provided civil and criminal immunity; however, data analysis rendered the apparent association statistically insignificant. Qualitative data were also collected in the form of respondents’ recommendations and additional comments.Conclusions: Physicians vary in their knowledge and opinions regarding the POLST paradigm. Broad opportunities may exist to improve physician knowledge and attitudes toward POLST. Dissemination of educational materials to physicians involved in the end-of-life planning process may increase physician support and use of POLST.

scholarly journals General Practitioner Residents and Patients End-of Life: Involvement and Consequences

2020 ◽  
Author(s):  
Victoire Haardt ◽  
Amélie Cambriel ◽  
Sidonie Hubert ◽  
Marc Tran ◽  
Cédric Bruel ◽  
...  
Keyword(s):  
General Practitioner ◽  
End Of Life ◽  
End Of Life Care ◽  
Private Life ◽  
Personal Life ◽  
Life Care ◽  
Advanced Directives ◽  
Dying Patients ◽  
Perception Management ◽  
Close Relatives

Abstract The ageing of the population and the increased number of chronicle diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training.Our aim was to know how they feel about this kind of work, very different from the one they are training to do.MethodWe surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days. Results:525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were unreasonable obstinacy (59.6%), patient’s (210 answers, 40%) relative’s communication (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychological follow up should be instituted for those working in “at risk” hospital settings. Conclusion:Self-perception management of dying patients by MG resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life.

scholarly journals The impact of inpatient palliative care on end-of-life care among older trauma patients who die after hospital discharge

2018 ◽  
Vol 85 (5) ◽  
pp. 992-998 ◽  
Author(s):  
Elizabeth J. Lilley ◽  
Katherine C. Lee ◽  
John W. Scott ◽  
Nicole J. Krumrei ◽  
Adil H. Haider ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Hospital Discharge ◽  
End Of Life Care ◽  
Trauma Patients ◽  
Life Care ◽  
The Impact

scholarly journals Role of Nativity in End of Life Care Planning

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 959-959
Author(s):  
Kay Thwe Kyaw ◽  
Elizabeth Helzner ◽  
Carl Rosenberg ◽  
Michael Reinhardt
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Cox Proportional Hazards ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Life Care ◽  
Foreign Born ◽  
Comfort Care ◽  
Advanced Directives ◽  
Weibull Models

Abstract Given the rapidly aging population, optimal end-of-life (EOL) consistent with individual wishes is a public health priority. Advanced Care Planning (ACP) involves Advanced Directives (AD) and establishing a Power of Attorney (POA). AD describe EOL Care preferences including options to limit treatment, withhold treatment, provide comfort care, and prolong treatments. Nativity can provide meaningful guidance in decision-making at the end of life. Data from this study came from the Health and Retirement Study, nationally representative longitudinal study of U.S. residents. The sample included 4,015 older adults, 65 and above years of age who died during study follow-up. Nativity was categorized as U.S born and Foreign born. ACP variables included presence of AD and POA, and EOLC preferences included provide comfort care, limit, withhold, or prolong treatment. Covariates included age, gender, race, marital status, education, and subjective health at baseline. Cox Proportional Hazards (Cox PH) and Weibull Models were used to identify associations between nativity and end of life care. Results: Compared to U.S born, Foreign born participants were less likely to have POA (HR: 0.75; 95% CI:0.64-0.89) in Cox PH and POA (HR: 0.63; 95 % CI:0.53-0.75) Weibull models in unadjusted models, limited treatment (HR: 1.58; 95 % CI: 1.2, 2.1), and prolong treatment (HR: 0.23; 95 % CI:0.06-0.99) and Cox PH and (HR: 0.20; 95 % CI: 0.05-0.83) in Weibull modes. Conclusion: There are differences in Advanced Care Planning by nativity. Country of origin should be considered when helping individuals plan for end-of-life care.

scholarly journals A kommunikáció és az önrendelkezés javításának lehetőségei az életvégi döntések meghozatalánál az intenzív osztályokon

2016 ◽  
Vol 157 (17) ◽  
pp. 669-674 ◽  
Author(s):  
László Zubek
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Medical Science ◽  
Legal Regulation ◽  
Decision Making Process ◽  
Life Care ◽  
Advanced Directives ◽  
Substituted Judgement ◽  
End Of Life Decision

The end-of-life decision making process normally based on patient autonomy or substituted judgement. If the patient can express his/her wishes, one must take note of his autonomy. If he/she is unable to self-determination, the importance of advanced directives or substituted judgement increases in the field of end-of-life care. The most important target of the efforts is to improve end-of-life care at intensive care units. Based on bioethical studies of the author and international literature this paper analizes the practice of end-of-life care and presents recommendations for lawmakers. The author proposes to divide patients with organ failure into three parts (end-of-life triage). The first part includes definitely salvageable, the second part definitely unsalvageable, and the third part possibly salvageable groups. This classification depends on the development of medical science and the local options of medical treatment. The quality of the decision-making process can be improved, but all participants must participate and medio-legal regulation must be improved. Orv. Hetil., 2016, 157(17), 669–674.

Effect of Religion on End-of-Life Care Among Trauma Patients

2014 ◽  
Vol 54 (3) ◽  
pp. 977-983 ◽  
Author(s):  
Myrick C. Shinall ◽  
Oscar D. Guillamondegui
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Trauma Patients ◽  
Life Care
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